| NPI | 1205368289 |
|---|---|
| Entity Type | Individual |
| Gender | Female |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME177962) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036.157749) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| 207Q00000X Family Medicine (Licence: CA A174215) | |
| Enumeration Date | 2017-03-30 |
| Last Update Date | 2026-05-22 |